Johnson J Aaron, Seale J Paul, Shellenberger Sylvia, Velasquez Mary M, Alick Candice, Turk Katherine
Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA.
School of Social Work, University of Texas-Austin, Austin, TX.
Adv Med Educ Pract. 2014 May 7;5:133-9. doi: 10.2147/AMEP.S56176. eCollection 2014.
Alcohol screening and brief intervention (SBI) reduces drinking among at-risk drinkers. Lack of training and negative attitudes represents a barrier to SBI performance. This study evaluates the impact of a medical student workshop using recovering alcoholics in simulated patient interviews to teach SBI skills.
Third-year students (n=94) were surveyed before and after a 3-hour alcohol SBI workshop regarding their perceived importance and confidence in performing eleven SBI behaviors. Students were also asked to list factors increasing and decreasing motivation to conduct SBI. Students completing off-campus rotations (n=71) served as controls, completing surveys during the same time period but without attending the workshop.
Analysis of variance found a significant interaction effect between the students participating in the workshop and control students on both importance scores [F(2,174)=3.34] and confidence scores [F(2,174)=9.13], indicating higher scores for the workshop students at the follow-up time periods. Commonly listed motivators for performing SBI included clinical experience with alcohol misuse and the impact of alcohol on health and relationships. High relapse rates and patient reactions to questions about alcohol use decreased the motivation to perform SBI.
SBI workshops that include recovering alcoholics as simulated patients can produce long-term improvements in students' perceived importance and confidence in performing SBI.
酒精筛查与简短干预（SBI）可减少高危饮酒者的饮酒量。缺乏培训和消极态度是实施SBI的障碍。本研究评估了一个医学生工作坊的影响，该工作坊利用戒酒康复者进行模拟患者访谈来教授SBI技能。
对94名三年级学生在参加为期3小时的酒精SBI工作坊前后进行调查，询问他们对执行11种SBI行为的重要性感知和信心。还要求学生列出增加和减少进行SBI动机的因素。71名完成校外轮转的学生作为对照组，在同一时间段内完成调查，但未参加该工作坊。
方差分析发现，参加工作坊的学生和对照学生在重要性得分[F(2,174)=3.34]和信心得分[F(2,174)=9.13]上均存在显著的交互作用，表明在随访期间工作坊学生的得分更高。实施SBI的常见动机包括酒精滥用的临床经验以及酒精对健康和人际关系的影响。高复发率和患者对饮酒问题的反应降低了实施SBI的动机。
将戒酒康复者作为模拟患者的SBI工作坊可使学生在实施SBI方面的重要性感知和信心得到长期改善。
